Babies born under 1000 g--perinatal outcome

Area of Science:

• Neonatal Medicine
• Perinatal Epidemiology
• Pediatric Critical Care

Background:

• Advances in obstetric and neonatal care have improved survival for very premature infants.
• Data specific to Northern Ireland's population for extremely low birthweight (ELBW) infants was lacking.
• Evaluating mortality and morbidity in ELBW infants is crucial for regional healthcare planning.

Purpose of the Study:

• To assess the survival rates and associated morbidities of extremely low birthweight (ELBW) infants born in Northern Ireland.
• To identify factors influencing survival, such as gestational age, birthweight, and maternal care.
• To provide population-specific data for improving neonatal intensive care.

Main Methods:

• Retrospective analysis of 77 ELBW infants (<1000 g) admitted within the first day of life (April 1990 - April 1992).
• Data collected included gestational age, birthweight, CRIB scores, maternal steroid use, and place of birth.
• Cranial ultrasonography was used to assess for severe neonatal brain injury (IVH/PVL).

Main Results:

• Overall survival rate for ELBW infants was 65% (50 out of 77), with survivors discharged at a mean age of 95 days.
• Survival was higher for infants receiving maternal steroid therapy or born at the study hospital.
• Severe neonatal brain injury (Papile grade 3-4 IVH/PVL) was present in 20% of survivors. Survival rates varied significantly by gestational age, from 0% at 23 weeks to 85% at 27 weeks.

Conclusions:

• The study demonstrates a 65% survival rate for ELBW infants in a Northern Ireland tertiary unit during 1990-1992.
• Maternal steroid therapy and in-hospital birth were associated with improved survival outcomes.
• Gestational age is a critical determinant of survival, with significantly lower rates for extremely preterm infants (<24 weeks GA).